Fatigue common with brain fog among adults with hypothyroidism

The effectiveness of this synthetic hormone on the cognitive function of people with subclinical hypothyroidism is less clear. LT4 improved memory in 4 trials on 135 adults and 20 children, but not in 3 trials on over 200 adults 31, 104, 105, 106, 107, 108, 109. LT4 reduced memory deficits in a clinical trial on 24 breastfeeding synthroid elderly people with hypothyroidism and maintained its effectiveness in the long term in a study on over 1k. Similarly, it improved cognitive function and behavior at school in a clinical trial on 18 children 36, 103, 37. The resulting hypothyroidism, together with the toxicity of sedatives to the brain and frequent fasting, may result in “brain fog”-like symptoms in people undergoing major surgery 89, 90, 84.

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As you work with your practitioner to pinpoint the optimal synthroid dosage and continue taking the medication, hot flashes may subside. Because the symptoms of hypothyroidism are often nonspecific and easily missed, and brain fog is often attributed to aging, stress, menopause, or some other cause, people with thyroid issues often go under the radar. (Up to 60 percent of people with thyroid disease are unaware of their condition.) Patients can only get a diagnosis of underactive thyroid by having a doctor look at symptoms in their totality and carry out the necessary tests.. Participants reported experiencing brain fog often, with 79.2% having brain fog “frequently” or “all the time.” Over half of all participants (56.4%) reported brain fog lasting all day. Nearly half of all participants (46.6%) reported experiencing brain fog prior to the diagnosis of hypothyroidism.

What are treatment options?

Because these symptoms are generally subjective, doctors can consider them too mild or unspecific to diagnose cognitive impairment. This mechanism fine-tunes T3 and T4 production and maintains their levels within normal values 2. Due to some participants offering more than 1 factor, the proportions were calculated from the total number of factors provided from all participants. Some people with hyperthyroidism, such as Graves’ disease, commonly experience poor concentration, slower reaction times, decreased spatial organization, and memory lapses.

Retrospective data suggest that many patients experience brain fog symptoms before the diagnosis of hypothyroidism (4) and are disappointed when LT4 therapy does not resolve all their symptoms (5,6). The textual data analysis revealed 2 prominent areas of concern (symptom-centric and medical-centric) that were not addressed among the symptom domains included in the survey. Patients used words related to memory, language, medication, and the patient-doctor relationship to indicate important aspects of brain fog. One particular symptom that patients often report is brain fog, which is described as a group of symptoms including low energy, forgetfulness, sleepiness and difficulty focusing. Interestingly, while this symptom is frequently reported in patients with hypothyroidism, it is also reported by patients with other medical conditions, such as lupus, chronic fatigue syndrome, COVID-19 (“long COVID”) and depression.

Also, nearly half the participants reported experiencing brain fog symptoms before their hypothyroidism diagnosis. This indicates that brain fog is likely a symptom of thyroid disorder rather than a side effect of thyroid hormone replacement therapy. In the absence of proven treatments for brain fog symptoms in hypothyroid people, some commonsense approaches can be tried (Fig. 1). Optimizing LT4 doses and maintaining serum TSH levels in the reference range is an obvious first approach, although the unimpressive neurocognitive data in treating mild hypothyroidism suggest that this may have only minor effects. Some patients with self-reported brain fog describe improvement with LT3 in online surveys (32,89).

• Further research is needed to determine the roles of both thyroid function and comorbidities in the character and severity of brain fog in hypothyroidism.
• The most frequent symptoms respondents listed were lack of energy, forgetfulness and sleepiness.
• There are models to help understand and predict the interplay of psychological adaptation and chronic medical conditions, which provide additional insights into possible relationships between hypothyroidism and psychological distress.
• Although mainstream sources of information provide balanced perspectives, there are many sources such as the internet or social media that promulgate skewed information and opinions, which could affect reports of symptoms.

thoughts on “Synthroid (Levothyroxine) Side Effects & Adverse Reactions”

This includes those with mutated variants of the enzyme that breaks down T4 into T3 (type 2 deiodinase), thyroid cancer, or who have undergone thyroid removal 118, 119, 120, 121. The hypothalamus produces thyrotropin-releasing hormone (TRH), which activates the pituitary to produce and release thyroid-stimulating hormone (TSH). The production of these hormones is regulated by a system involving the hypothalamus, pituitary, and thyroid gland – the hypothalamus-pituitary-thyroid axis. SelfHacked has the strictest sourcing guidelines in the health industry and we almost exclusively link to medically peer-reviewed studies, usually on PubMed.

Inclusion and Exclusion Criteria Considerations When Studying Hypothyroid-Associated Brain Fog

The preliminary data from Shakir et al. (48) suggest that the most symptomatic patients may derive the greatest benefit from LT4/LT3 combination therapy, although other intervention studies have been less impressive in unselected patients. As clinicians, we struggle to help patients with persistent symptoms, despite adequate treatment with thyroid hormone. Over 58% of subjects in this study attributed improvement in their symptoms to adequate rest and relaxation, followed by exercise and some dietary modifications. Interestingly, 46% of subjects reported “brain fog” symptoms prior to their diagnosis of hypothyroidism, which points to a multifactorial etiology of this condition. This study emphasizes the importance of engaging our patients in a conversation about behavioral and lifestyle modifications, in addition to adequate thyroid hormone supplementation, to achieve optimal health. Treating hypothyroidism with thyroid hormone replacement (levothyroxine) is the best way to alleviate symptoms of brain fog.

That said, it may take a couple of weeks for severe brain fog to subside after starting treatment. In the event that it doesn’t improve, prescription of an adjunct pharmaceutical may be warranted to enhance clarity of thought. If prior to taking synthroid you have a history of blood pressure abnormalities, your doctor should be well-informed of these and adjust dosing to mitigate risks of hypertension. In some cases, synthroid users may necessitate adjuvant treatment with a beta blocker to offset the side effect of hypertension. The greater the dosage of synthroid you’re taking, the more likely you’ll be to experience hypertension as an adverse reaction. In a clinical trial on 70 people with hypothyroidism, this extract was as effective as LT4 alone at improving the symptoms (including cognitive problems).

If your joint pain continues to worsen, interferes with your ability to exercise and/or well-being – you may need to evaluate other treatment options. Some individuals report that bloating experienced on synthroid is also accompanied by weight gain. To minimize the likelihood of bloating while taking synthroid, be sure to eat a clean, healthy diet (devoid of processed foods – as these can exacerbate existing bloating). If the synthroid is causing your stomach to swell significantly (e.g. to the extent that you appear pregnant) and this bloat is interfering with your ability to function – talk to your doctor about potential alternatives.

For certain users, swelling may be most noticeable when first beginning treatment and thereafter, it may completely subside. That said, the swelling may be significant enough to cause joint and/or muscle pain – especially if it worsens over time. To ensure that your fingernails stay healthy while taking synthroid, you may need to carefully monitor your nutritional intake as well as consider various adjunct dietary supplements.